School of Psychological Sciences and Turner Institute for Brain and Mental Health, Monash University, Melbourne, Victoria, Australia; Monash Addiction Research Centre, Monash University, Victoria, Australia.
School of Psychological Sciences and Turner Institute for Brain and Mental Health, Monash University, Melbourne, Victoria, Australia.
Drug Alcohol Depend. 2023 May 1;246:109846. doi: 10.1016/j.drugalcdep.2023.109846. Epub 2023 Mar 20.
Deficits in executive function are common in methamphetamine use disorder (MUD), likely contributing to difficulties in sustained treatment success. Cognitive remediation interventions are designed to treat such deficits but have not been adapted to the needs of people with MUD. This study presents a proof-of-concept trial to evaluate a new cognitive remediation program for MUD, Goal Management Training (GMT).
This was a cluster-randomised crossover trial comparing GMT with a psychoeducation-based control (Brain Health Workshop; BHW). GMT is a therapist-administered group-based cognitive remediation for executive dysfunction comprising four 90-minute weekly sessions and daily journal activities. BHW is a lifestyle psychoeducation program matched to GMT for therapist involvement, format, and duration. Participants (n = 36; GMT n = 17; BHW n = 19) were recruited from therapeutic communities in Victoria, Australia. Primary outcomes included intervention acceptability, feasibility, and improvements in self-reported executive function. Secondary outcomes included cognitive tests of executive function, severity of methamphetamine dependence, craving, and quality of life. We performed mixed linear modelling and calculated Hedges' g effect sizes.
GMT participant ratings and program retention indicated high acceptability. There was no difference between GMT and BHW on self-reported executive function (g = 0.06). Cognitive tasks suggested benefits of GMT on information gathering (g = 0.88) and delay-discounting (g = 0.80). Severity of methamphetamine dependence decreased more in GMT (g = 1.47).
GMT was well-accepted but did not improve self-reported executive functioning. Secondary outcomes suggested GMT was beneficial for objective cognitive performance and severity of dependence.
在冰毒使用障碍（MUD）中，执行功能缺陷很常见，这可能导致持续治疗成功的困难。认知矫正干预旨在治疗这些缺陷，但尚未适应 MUD 患者的需求。本研究提出了一项概念验证试验，以评估一种新的 MUD 认知矫正计划，即目标管理培训（GMT）。
这是一项集群随机交叉试验，比较了 GMT 与基于心理教育的对照（大脑健康工作坊；BHW）。GMT 是一种由治疗师管理的基于小组的执行功能认知矫正，包括四个每周 90 分钟的会议和日常日记活动。BHW 是一种与 GMT 相匹配的生活方式心理教育计划，在治疗师参与、格式和时长方面都相匹配。参与者（n=36；GMT n=17；BHW n=19）是从澳大利亚维多利亚州的治疗社区招募的。主要结果包括干预的可接受性、可行性以及自我报告的执行功能的改善。次要结果包括执行功能的认知测试、冰毒依赖的严重程度、渴求程度和生活质量。我们进行了混合线性模型分析，并计算了 Hedges' g 效应大小。
GMT 参与者的评价和项目保留率表明其具有高度的可接受性。GMT 和 BHW 在自我报告的执行功能方面没有差异（g=0.06）。认知任务表明 GMT 在信息收集（g=0.88）和延迟折扣（g=0.80）方面具有优势。冰毒依赖的严重程度在 GMT 组中下降更多（g=1.47）。
GMT 虽然很受欢迎，但并没有改善自我报告的执行功能。次要结果表明，GMT 对客观认知表现和依赖的严重程度有益。
